Emergent reintubation following elective cervical surgery: A case series

Table 1 Patient demographic parameters

No.	Gender	Age (yr)	BMI	Smoking Status	Comorbidities
Case 1	Male	53	29.3	Never	Hyperlipidemia
Case 2	Female	70	26.7	Never	hypertension, Von willebrand disease, hypoglycemia, visual migraines
Case 3	Male	44	23.7	Current, 15 P-Y	-
Case 4	Male	58	26.5	Former, 15 P-Y	Diabetes mellitus type I, asthma
Case 5	Female	58	22.9	Never	Rheumatoid arthritis, hypertension, GERD
Case 6	Male	56	27.7	Never	Coronary artery disease, hypertension, benign prostate hyperplasia
Case 7	Female	71	29.3	Current, 8 P-Y	COPD, pulmonary hypertension, obstructive sleep apnea, GERD
Case 8	Female	51	25.6	Never	-
Case 9	Female	61	21	Never	GERD

P-Y: Pack-years; GERD: Gastroesophageal reflux disease; BMI: Body mass index; COPD: Chronic obstructive pulmonary disease.

Table 2 Primary operative details

No.	Cord signal change (MRI)	Symptoms	Operated levels	Approach	Operative time (min)	Estimated blood loss (mL)
Case 1	Yes	Neck- and hand pain, gait change, paresthesias	C3-7	Anterior	360	750
Case 2	Yes	Upper extremity weakness, shoulder pain, paresthesias	C2-6	Combined	690	750
Case 3	Yes	Right arm pain	C3-7	Anterior	390	850
Case 4	Yes	Shoulder pain, paresthesias	C3-7	Anterior	570	800
Case 5	Yes	Gait change, numbness, weakness	C4-T3	Combined	600	950
Case 6	Yes	Neck pain, numbness, gait change	C3-7	Anterior	330	300
Case 7	Yes	Neck pain, gait change	C2-T6	Combined	660	1100
Case 8	No	Neck pain, shoulder pain	C4-6	Anterior	270	150
Case 9	Yes	Neck pain, shoulder pain, gait change, decreased fine motor control	C3-7	Anterior	270	100

MRI: Magnetic resonance imaging.

Table 3 Postoperative airway management

No.	Primary post-opextubation (d)	Time to reintubation (min)	Symptoms preceding reintubation	Diagnosis	Length of reintubation (d)	Therapeutic measures
Case 1	1	360	Dyspnea, stridor	Pharyngeal edema	2	Decadron
Case 2	1	600	Hypoxemia (70%)	Hematoma	3	Surgical evacuation
Case 3	0	60	Coughing white, thick mucous	Pulmonary edema	2	Decadron, epinephrine, diuretics
Case 4	0	60	Hypoxemia (80%)	Pharyngeal edema	3	-
Case 5	1	600	Dyspnea, stridor	Pharyngeal edema	3	Decadron, epinephrine
Case 6	0	60	Coughing whilst intubated: Inadvertently extubated	Pharyngeal edema	2	-
Case 7	4	720	Hypoxemia (70%-80%)	Pharyngeal edema	2	-
Case 8	0	420	Dyspnea, dysphagia, dysphonia	Pharyngeal edema	2	-
Case 9	0	480	Dyspnea	Pharyngeal edema	3	Decadron, epinephrine

Table 4 Follow-up

No.	Residual complaints
Case 1	Persistent neck pain and numbness
Case 2	Trapezius pain, paresthesias
Case 3	Residual neck pain
Case 4	-
Case 5	-
Case 6	-
Case 7	Intermittent neck pain, radiculopathy of the right arm
Case 8	Not reported
Case 9	Intermittent neck pain, paresthesias, headaches, numbness and paresthesias of the left thumb and index finger